Determinants of Health Care Renunciation among Women in Ivory Coast: Case of the District of Abobo Anonkoi-3

Authors

  • Jérôme Kouame Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Center for Research and Studies in Populations, Policies and Health Systems, National Institute of Public Health, Abidjan, Ivory Coast
  • Julie-Ghislaine Sackou-Kouakou Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Center for Research and Studies in Populations, Policies and Health Systems, National Institute of Public Health, Abidjan, Ivory Coast
  • Marie-Laure Tiade Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Hygiene Laboratory, National Institute of Public Hygiene and health, Abidjan, Ivory Coast
  • Régine Attia-Konan Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Center for Research and Studies in Populations, Policies and Health Systems, National Institute of Public Health, Abidjan, Ivory Coast
  • Madikiny Coulibaly Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Aïssata Dagnogo Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Kouame Koffi Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Mariette Gokpeya Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Hygiene Laboratory, National Institute of Public Hygiene and health, Abidjan, Ivory Coast
  • Simone Malik Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Angèle Desquith Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Agbaya Oga Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Medical Information department, Institute of Cardiology, Abidjan, Ivory Coast
  • Kouakou Luc Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast
  • Kouadio Kouadio Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, Abidjan, Ivory Coast/ Hygiene Laboratory, National Institute of Public Hygiene and health, Abidjan, Ivory Coast

Abstract

Background: Health care renunciation aims to identify unmet care needs that a health con­dition would have justified. This behavior appears to be more common in women than in men. The objective of this work was to analyze the determinants of the health care renuncia­tion among women in the city of Abidjan.

Subjects and Method: We carried out a cross-sectional study from March to May 2019 in Anonkoi-3, a peri-urban district of the muni­cipality of Abobo, in the north of the city of Abidjan. Questionnaires served to collect infor­mations. Bivariate analyzes and a multiple logistic regression were used to measure the association between the different types of renunciation and the characteristics of women. Dependant variable was healthcare renuncia­tion. Independent variables were socio-demo­graphic, economic, health status characte­ristics and reasons for renouncing to health care.

Results: The population sample consisted of 423 women (with mean age= 32; SD= 12 years). The renunciation on consultations with the general practitioner concerned, 72.34% of women. Regarding consultation with the spe­cialist, the ophthalmologist (25.05%), the dentist (21.99%), and the gynecologist (14.89%) were those mostly renounced by the women. After consultation, 31.2% of them renounced to pursuing other treatment. They most often renounced to buying drugs from conventional medicine (19.62%) and preferred to use street drugs and traditional drugs (87.71%). All things being equal, women aged 28 to 38 (OR= 2.45; 95% CI= 1.31 to 4.68; p= 0.013), artisans and traders (OR= 3.22; 95% CI= 1.48 to 7.38; p= 0.004) and those in trade learning (OR= 2.42; 95% CI= 1.12 to 5.49; p= 0.028) significantly renouncing more on health care.

Conclusion: In addition to financial reasons, the renunciation on health care can be explained by individual and social behaviors specific to individuals.

Keywords: women, healthcare renunciation, precariousness, social inequalities, ivory coast

Correspondence: Jérôme Kouame, Faculty of Pharmaceutical and Biological Sciences, Department of Public Health, Hydrology and Toxicology, University Félix Houphouët Boigny, BPV 34 Abidjan 01, Ivory Coast. Email: jerome.kouamejj­@­gmail.­com. Mobile: 0022565237900.

Journal of Health Policy and Management (2021), 06(02): 116-129
https://doi.org/10.26911/thejhpm.2021.06.02.04

References

Agence Belge de developpement (2012). Les femmes, Actrices du commerce équitable: Femmes et développe-ment. Available at: https://www.-befair.be/drupal_files/public/all-file-s/brochu-re/FEMMES_CE_FR_Web.pdf.

Allin S, Grignon M, Le Grand J (2010). Subjective unmet need and utilization of health care services in Canada: What are the equity implications?. Soc Sci Med, 70(3): 465–472. doi: 10.-1016/j.socscimed.2009.10.027.

Allonier C, Dourgnon P, Rochereau T (2010). Enquête sur la santé et la protection sociale 2012,IN Institute for Research and Information in Health Economics (IRDES). Available at: https://www.irdes.fr/Publications-/Rapports2010/rap1800.pdf.

Ancelot L, Bonnal L, Depret M-H (2016). Déterminants du renoncement aux soins des femmes durant leur gros-sesse. Rev fr écon. 31(4): 63. doi: 10.-3917/rfe.164.0063.

Baggio S, Iglesias K, Fernex A (2017). Healthcare renunciation among young adults in French higher educa-tion: A population-based study. Prev Med. 99: 37–42. doi: 10.1016/j.yp-med.2017.02.002.

Bazin F, Parizot I, Chauvin P (2006). Déter-minants psychosociaux du renonce-ment aux soins pour raisons finan-cières dans cinq zones urbaines sensibles de la Région parisienne en 2001. Sci Soc Sante. 24(3): 11. doi: 10.3917/sss.243.0011.

Bouba-Olga O, Vigé M, Vigé B-O (2014). Healthcare renunciation: An empirical analysis from SHARE. Available at: https://hal.archives-ouvertes.fr/hal-01070962/document.

Centre International de solidarité ouvrière (2002). Le travail des femmes à l’heure de la mondialisation néo-libérale. Canadian Woman Studies, 21(4): 1–12. Available at: https://-www.ciso.qc.ca/wordpress/wp-con-tent/uploads/CISO-Fiche-A4.pdf.

Chaupain-Guillot S, Guillot O, Jankelio-witch-Laval E (2014). Le renoncement aux soins médicaux et dentaires: une analyse à partir des données de l’enquête SRCV. Econ Stat, 469(1): 169–197. doi: 10.3406/estat.2014.10426.

Chauvin P, Renahy E, Parizot I, Vallée J (2011). Le renoncement aux soins pour raisons financières dans l’ agglo-mération parisienne: Déterminants sociaux et évolution entre 2005 et 2010. https://hal.archives-ouvertes.-fr/inserm-00645136.

Després C, Dourgnon P, Fantin R, Jusot F (2011a). Le renoncement aux soins: une approche socio-anthropologique Question d’économie de la santé, Novembre (169): 1–6. Available at: http://www.irdes.fr/Publications/20-11/Qes169.pdf.

Després C, Dourgnon P, Fantin R, Jusot F (2011b). Le renoncement aux soins pour raisons financières: une appro-che économétrique. Question d’économie de la santé, Novembre (170): 1–6. Available at: http://-www.irdes.fr/Pu-blications/2011/Qes170.pdf.

Desprès C (2013). Significations du renon-cement aux soins: Une analyse anthropologique, Sci Soc Sante, 31(2): 71–96. doi: 10.1684/sss.2013.0205.

Dourgnon P, Jusot F, Fantin R (2012). Payer nuit gravement à la santé : une étude de l’impact du renoncement financier aux soins sur l’état de santé. Écon. publique, (28–29): 123–147. doi: 10.4000/economiepublique.8851.

Guessous I, Theler JM, Durosier Izart C, Stringhini S, Bodenmann P, Gaspoz J-M, Wolff H (2014) . Forgoing dental care for economic reasons in Switzer-land: A six-year cross-sectional popu-lation-based study. BMC Oral Health, 14(1): 1–10. doi: 10.1186/1472-6831-14-121.

Hartnett E, Haber J, Krainovich-Miller B, Bella A, Vasilyeva A, Lange Kessler J (2016). Oral Health in Pregnancy. J Obstet Gynecol Neonatal Nurs, 45(4), pp. 565–573. doi: 10.1016/j.jogn.20-16.04.005.

Institut National de la statistique de Côte d’Ivoire (2015) . Récensement général dela population et de l'habitat 2014. Résultats globaux. Available at: http://www.ins.ci/n/templates/docss/RGPH2014D.pdf.

Jusot F (2013). Les inégalités de recours aux soins: bilan et évolution. Rev Epidemiol Sante Publique. 61: S163–S169. doi: 10.1016/j.respe.2013.05.011.

Ministère de la santé et de l’hygiène publi-que République de Côte d’Ivoire (2018). Rapport annuel sur la situa-tion sanitaire (rass) 2018. Abidjan. Available at: http://dipe.info/index.-php/fr/component/jdownloads/summary/6-rapport-annuel-sur-la-situa-tion-sanitaire/61-rass-2018-vf.

Revil H (2017). Femmes et hommes face au renoncement aux soins. La Santé en action. Available at: http://www.-sfsp.-fr/manifestations/manifestations/communication.php?com=1037.

Revil H, Casagrande A, Chauveaud C (2016). Diagnostic quantitatif du renoncement aux soins des assurés de 18 Caisses Primaires d’ Assurance Maladie (CPAM) Juin 2016. Grenoble. Available at: https://odenore.msh-al-pes.fr/documents/analyse_diagnostic_quantitatif_-_odenore_-_vf.pdf.

Schwartz D (1995). Methodes Statistiques à l'usage des Medecins et des Biologis-tes, Flammarion. doi: 10.2307/233-4183.

Tuckett D (2013). An introduction to medi-cal sociology. 2013th ed, An Intro-duction to Medical Sociology. 2013th edn. Routledge. Tavistock Press. doi: 10.4324/9781315823843.

United Nations (2000). Rapport de la Com-mission de la condition de la femme constituée en comité préparatoire de la session extraordinaire de l’ Assem-blée générale intitulée « Les femmes en l ’ an 2000: égalité entre les sexes, développement et

paix pour le XXIe siècle » sur. Available at: https://un-docs.org/pdf?symbol=fr/A/S-23/2.

Warin P, Chauveaud C (2015). Le Baro-mètre du renoncement aux soins dans le GARD. Available at: https://hal.archives-ouvertes.fr/hal-01099989.

Wolff H, Gaspoz JM, Guessous I (2011). Health care renunciation for econo-mic reasons in Switzerland. Swiss Med Wkly. 141: 18–21. doi: 10.4414/-smw.2011.13165.

World Health Organisation (2009). 10 Facts on Women's Health. Available at: https://www.who.int/gender/docu-ments/10facts_womens_health-_en.pdf?ua=1.

World Health Organisation (2018). La santé des femmes. Available at: https://-www.who.int/fr/news-room/fact-she-ets/detail/women-s-health (Accessed on 22 October 2020).

Downloads

Published

30-05-2021

How to Cite

Kouame, J., Sackou-Kouakou, J.-G., Tiade, M.-L., Attia-Konan, R., Coulibaly, M., Dagnogo, A., Koffi, K., Gokpeya, M., Malik, S., Desquith, A., Oga, A., Luc, K., & Kouadio, K. (2021). Determinants of Health Care Renunciation among Women in Ivory Coast: Case of the District of Abobo Anonkoi-3. Journal of Health Policy and Management, 6(2), 116–129. Retrieved from http://thejhpm.com/index.php/thejhpm/article/view/199

Issue

Section

Articles